Rising to the top

ON March 15, 2020, the coronavirus disease 2019 (Covid-19) reached Davao Region.

Eventually, this led to the implementation of a series of community quarantines.

In Davao City, the community quarantine was implemented on March 15, enhanced community quarantine (ECQ) on April 4, general community quarantine (GCQ) on May 16, and MGCQ on July 1.

The quarantine measures were put in place to limit the movement of the people through the implementation of various guidelines -- 24-hour liquor ban, curfew, food and medicine pass, and the clustering system.

The effectiveness of these guidelines was evident in the number of new cases. Daily data from the Department of Health in Davao Region (DOH-Davao) showed that between March until around the end of August, new cases in the city were well below the 50s with most days being in the single digits.

However, the low number of new cases could also be attributed to the city having only two accredited Covid-19 testing facilities -- the Southern Philippines Medical Center and the Davao One World Diagnostic Center Inc. Coupled with this, health authorities and local government officials have also previously raised concerns over struggles with contact tracing.

As the MGCQ progresses, this allowed the city government to slowly lift its guidelines limiting the movement of individuals. The city first lifted the use of the food and medicine passes and then the curfew. On September 21, 2020, the liquor ban was lifted.

However, as movement restrictions were lifted, the city saw an expected spike in Covid-19 cases.

Towards the end of September, there has been a steady rise in active cases in the city. Between March until the last week of September, active cases in the city were below the 300-mark.

However, On September 29, total active cases in the city breached the 300-mark when it hit 310 after logging 55 new cases on that day.

Since then, the active cases saw a steady rise as it records double-digits in new cases with most days recording over 35 new cases.

In less than a week after hitting the 300-mark, the city reached the 400-mark on October 4 when it hit 425 after logging 47 new cases.

Nine days later, active Covid-19 in the city reached the 500-mark when it logged 53 new cases on October 10, bringing active cases to 514.

In a week, active Covid-19 cases in the city climbed to 616 after logging 81 new Covid-19 cases, breaching the 600-mark.

Then in two days, active Covid-19 cases in the city breached the 700-mark after it logged 73 new cases on October 22, bringing active cases in the city to 716.

It can also be noted that between October 18 to 24, the city set record-breaking numbers of new cases in the city. On October 20 it recorded 81 new cases, 94 on October 21, 73 on October 22, 76 on October 23, and 118 on October 24. October 24 had the highest of new cases in a single day in Davao City.

It was also in the same week when Davao City had the highest number of new Covid-19 cases in the country. Data from DOH Central Office, which may be different from the numbers of DOH-Davao, showed that the city had a total of 99 new cases on October 23.

As of October 24, Davao City has already logged 1,167 new Covid-19 cases, 655 new recoveries, and 55 new deaths related. To date, October also has the highest number of new deaths and new recoveries in the city.

DOH-Davao regional director Dr. Anabelle Yumang said on October 21 that Talomo North, District C, Buhangin, and Agdao are the areas in the city recording a high number of Covid-19 cases. The agency has yet to provide additional information on the area covered by District C.

The high number of new cases in Davao City also led to the surge of the total caseload and active cases in the region. The region recorded a high number of new Covid-19 cases from October 20 to 24. On October 20 it logged 90 cases, 123 on October 21, 103 on October 22, 93 on October 23, and 156 on October 156. The bulk of the new cases are from Davao City.

The increase in new cases saw Davao Region breach the 1,000-mark in active cases on October 23 when it reached 1,012. As of October 24, the region has 1,074 active cases, the fifth-highest in the country.

DOH-Davao Assistant Director Lenny Joy Rivera said during the October 16 edition of the One Davao On Covid-19 virtual presser that the attack rate and growth rate in the city have increased. The two-week growth rate is a measurement that shows how quickly the number of cases is changing in the two-week period while the attack rate provides the incidence or how many confirmed positive cases per 100,000 population.

Based on DOH-Davao's data as of October 15, the city's current two-week growth rate is at 60.10 percent, compared to the 43.60 percent recorded in the past three to four weeks. While the city's daily average attack has increased from 1.2 to 2 percent.

As the active cases in the city and the region increase, the occupancy rate for allotted Covid-19 intensive care unit (ICU) and ward beds at SPMC have either reached full occupancy or near full occupancy. The hospital allocates 30 ICU beds and 279 ward beds for Covid-19 patients.

Covid-19 patients at the SPMC are mostly either in severe or critical conditions. Asymptomatic and mild patients are mainly housed in temporary treatment and monitoring facilities. The SPMC is the primary Covid-19 hospital in the city.

On October 5 and 16, ICU beds at SPMC had an occupancy rate of 100 percent.

As of October 24, only three ICU beds were available for Covid-19 patients with 27 beds or 90 percent being occupied. For the wards, only six remain with 273 beds or 97.85 percent being occupied.

Dr. Julinda Acosta, technical division chief of Davao City Health Office, said based on the findings from the city’s contact tracing efforts, one of the culprits of the sudden surge in Covid-19 cases in the city is due to cluster cases in workplaces.

“For Davao City, sa pagtaas sa kaso diri, na-observe jud namo nga most of these cases are in the worksite. Kay na notice namo nga dili siya kalat, sa karon, pila ka weeks napansin namo nga naa sa trabahuan nga daghan kaayo and sa institutions (We noticed that the increase in Covid-19 cases in the city was found to be in workplaces),” she said during the One Davao On Covid-19 virtual presser on October 21.

Acosta said if there are three companies with each having 10 Covid-19 cases, that is already a big contributor to the daily number of new Covid-19 cases.

“Unilke before nga nagdahan ang kaso because it is in the community but karon naka-lump siya sa isa ka worksite (Before we had a surge in cases because it was mainly transmission within the community. Now, new cases are being lumped in worksites),” she said.

In response, on Friday, October 23, Davao City Vice Mayor Sebastian Z. Duterte, who was acting mayor on that day, issued EO 56, which orders public and private offices to implement alternative work arrangements like skeleton workforce, work-from-home, and staggered working hours.

“There is a need for massive reduction of individuals inside offices and establishments to ensure that overcrowding, mass gathering, and socialization are continuously prohibited,” Duterte said.

Acosta also said they also found that gatherings are also a culprit to the spread of the disease.

"Doon po namin nakikita na marami nagkakahawaan sa birthday party, sa mga wedding, mga special occasions (We saw a wide transmission of cases on birthday parties, weddings, and other special occasions)," Rivera said.

Acosta said the risk of transmission in gatherings is high because of the people coming from different areas.

“Sa party, like a simple birthday party nga naay relatives from other places, doon sila natakdan (Relatives coming to a simple birthday party could be infected with the virus there),” Acosta said.

Rivera said they have a case where one Covid-19 patient attended a party and had close contact with 27 individuals. Of the 27, 18 tested positive for the Sars-CoV-2, the virus causing the Covid-19.

Hence, Acosta and Rivera both agree that it is just about right that the city reimposes the curfew.

Davao City Mayor Sara Z. Duterte-Carpio reimposed the curfew and liquor ban in the city on October 15, 2020 through EO 55. Both are set from 7 p.m. to 5 a.m. While most accepted the reimposition of the liquor ban, the early curfew hours were met with controversy.

Duterte-Carpio in previous interviews said there is a need to control the movement of the people to curb the spread of the disease.

"We deemed it nga kinahanglan i-regulate kanang mga activities nga ginabuhat sa mga tao nga dili essential, dili sila sulod didto sa kanang ginasulti sa IATF (Inter-Agency Task Force on Emerging Infectious Diseases) Omnibus Guidelines (We deemed it necessary to regulate non-essential activities or those outside of the IATF Omnibus Guidelines)," she said.

Rivera further explained that based on the findings of their contact tracing, many gatherings happened after work, mostly starting at around 7 p.m.

Several days after issuing EO-55, the mayor issued EO 55-A, which expands the coverage of those who are exempted from the curfew.

The city also issued an advisory prohibiting the public from holding Christmas parties and trick-or-treating activities in a bid to limit the gathering of individuals.

“We have to limit movement, discourage gatherings, and also to really strictly implement safety protocols,” Acosta said.

Rivera also said the lack of observance of the minimum health protocols -- wearing of face masks or face shields, hand hygiene, and observing social distancing, may also be a culprit to the increase in new cases in both the city and the region.

Hence, she urges the public to observe the basic health protocols to slow the spread of the disease.

“Bawat isa, isapuso natin yung minimum health standards na hindi ka mahawa, hindi ka rin makakahawa. Kasi alam natin na maraming asymptomatic cases, kawawa naman ang mga vulnerable groups kung mahawa natin," Rivera said.

(We have to take to the minimum health standards to ensure that we do not get infected nor infect others. Many are asymptomatic, it would be bad if they infect someone who is among the vulnerable groups.)

As of October 24, Davao Region has 4,630 Covid-19 cases. Of this number, 3,397 have recovered, 159 have died, and 1,074 are active cases.

Davao City is the Covid-19 hotspot in the region with 3,120 total cases where 2,207 have recovered, 133 have died, and 780 are recovering. Davao del Norte has the second-highest number of total cases with 500; of this number, 376 have recovered, eight have died, and 116 are active cases.

Davao del Sur has 321 Covid-19 cases with 214 recoveries, 11 deaths, and 96 active cases. Davao Oriental has 313 Covid-19 cases with 284 recoveries, two deaths, and 27 active cases. Davao de Oro has 280 total cases with 236 recoveries, three deaths, and 41 active cases. Lastly, Davao Occidental has 96 total cases with 80 recoveries, two deaths, and 14 active cases.

From October 1 to 24, the region has already logged 1,554 new cases, 964 new recoveries, and 65 new deaths.


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